Main prognostic factors and physical therapy modalities associated with functional recovery in patients with peripheral facial paralysis
DOI:
https://doi.org/10.1590/1809-2950/19016727022020Keywords:
Facial Paralysis, Bell’s Palsy, Physical Therapy;, PrognosisAbstract
Patients with peripheral facial paralysis (PFP) have some degree of recovery. The aim of this study was to evaluate prognostic factors and physical therapy modalities associated with functional recovery in patients with PFP. This is a cohort study with 33 patients. We collected the following variables of patients who underwent treatment at the rehabilitation center: age, sex, risk factors, affected side, degree of facial paralysis (House-Brackmann scale), start of rehabilitation, and therapy modality (kinesiotherapy only; kinesiotherapy with excitomotor electrotherapy; and kinesiotherapy with excitomotor electrotherapy and photobiomodulation therapy). The outcomes were: degree of facial movement (House-Brackmann) and face scale applied 90 days after treatment. Degree of PFP was associated with functional recovery (RR=0.51, 95% CI: 0.51-0.98; p=0.036). The facial movement was associated with the time to start rehabilitation (r=−0.37; p=0.033). Lower facial comfort was observed among women, worse ocular comfort was associated with diabetes mellitus, worse tear control with prior PFP, and worse social function with the degree of PFP. Our results indicate that the all modalities present in this study showed the same result in PFP. Recovery of PFP was associated with degree of nerve dysfunction, the length of time to onset of rehabilitation, fem
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References
Lee DH. Clinical efficacy of electroneurography in acute
facial paralysis. J Audiol Otol. 2016;20(1):8-12. doi: 10.7874/
jao.2016.20.1.8
Finsterer J. Management of peripheral facial nerve palsy.
Eur Arch Otorhinolaryngol. 2008;265:743-52. doi: 10.1007/
s00405-008-0646-4
Bélec L, Gherardi R, Georges AJ, Schüller E, Vuillecard E,
Di Costanzo B, Martin PM. Peripheral facial paralysis and
HIV infection: report of four African cases and review of the
literature. J Neurol. 1989:236:411-4.
Vakharia K, Vakharia K. Bell’s Palsy. Facial Plast Surg Clin North
Am. 2016;24(1):1-10. doi: 10.1016/j.fsc.2015.08.001
Peitersen E. Bell’s palsy: the spontaneous course of 2,500
peripheral facial nerve palsies of different etiologies. Acta
Otolaryngol Suppl. 2002;549:4-30.
Jowett N. A general approach to facial palsy. Otolaryngol Clin
North Am. 2018;51(6):1019-31. doi: 10.1016/j.otc.2018.07.002
Hohman MH, Hadlock TA. Etiology, diagnosis, and management
of facial palsy: 2000 patients at a facial nerve center.
Laryngoscope. 2014;124(7):E283-93. doi: 10.1002/lary.24542
Eviston TJ, Croxson GR, Kennedy PG, Hadlock T, Krishnan AV.
Bell’s palsy: aetiology, clinical features and multidisciplinary
care. J Neurol Neurosurg Psychiatry. 2015;86(12):1356-61.
doi: 10.1136/jnnp-2014-309563
Marenda SA, Olsson JE. The evaluation of facial paralysis.
Otolaryngol Clin North Am. 1997;30(5):669-82.
Yeo SW, Lee DH, Jun BC, Chang KH, Park YS. Analysis of prognostic
factors in Bell’s palsy and Ramsay Hunt syndrome. Auris Nasus
Larynx. 2007;34:159-64. doi: 10.1016/j.anl.2006.09.005
Sillman JS, Niparko JK, Lee SS, Kileny PR. Prognostic value
of evoked and standard electromyography in acute facial
paralysis. Otolaryngol Head Neck Surg. 1992;107(3):377-81.
doi: 10.1177/019459989210700306
Veillon F, Taboada LR, Eid MA, Riehm S, Derby C, Schultz P,
Charpiot A. Pathology of the facial nerve. Neuroimag Clin N Am.
;18:309-320. doi: 10.1016/j.nic.2008.01.002
Baugh RF, Basura GJ, Ishii LE, Schwartz SR, Drumheller
CM, Burkholder R, et al. Clinical practice guideline: Bell’s
palsy. Otolaryngol Head Neck Surg. 2013;149 Suppl 3:S1-27.
doi: 10.1177/0194599813505967
Kubik M, Robles L, Kung D. Familial Bell’s palsy: a case
report and literature review. Case Rep Neurol Med. 2013;1-3.
doi: 10.1155/2012/674981
Almeida MAM. Paralisia facial periférica em Petrópolis. Arq NeuroPsiquiat. 1992;50:60-4. doi: 10.1590/S0004-282X1992000100011
Campbell K, Brundage J. Effects of climate, latitude, and season
on the incidence of Bell’s Palsy in the US Armed Forces, October
to September 1999. Am J Epidemiol. 2002;156:32-39. doi:
1093/aje/kwf009
Beurskens CH, Heymans PG. Physiotherapy in patients with
facial nerve paresis: description of outcomes. Am J Otolaryngol.
;25(6):394-400. doi: 10.1016/j.amjoto.2004.04.010
Cronin GW, Steenerson RL. The effectiveness of neuromuscular
facial retraining combined whit electromyography in facial
paralysis rehabilitation. Otolaryngol Head Neck Surg.
;128(4):534-8. doi: 10.1016/S0194-59980300005-6
Beurskens CH, Heymans PG. Positive effects of mime therapy
on sequelae of facial paralysis: stiffness, lip mobility, and
social and physical aspects of facial disability. Otol Neurotol.
;24(4):677-81. doi: 10.1097/00129492-200307000-00024
Cederwall E, Olsen MF, Hanner P, Fogdestam I. Evaluation
of a physiotherapeutic treatment intervention in “Bell’s”
facial palsy. Physiother Theory Pract. 2006;22(1):43-52. doi:
1080/09593980500422529
Shafshak TF. The treatment of facial palsy from the point of
view of physical and rehabilitation medicine. Eura Medicophys.
;42(1):41-7.
Fonseca KM, Mourão AM, Motta AR, Vicente LC. Scales of degree
of facial paralysis: analysis of agreement. Braz J Otorhinolaryngol.
;81(3):288-93. doi: 10.1016/j.bjorl.2014.04.005
Kahn JB, Gliklich RE, Boyev KP, Stewart MG, Metson RB, McKenna
MJ. Validation of a patient-graded instrument for facial nerve
paralysis: the FaCE scale. Laryngoscope. 2001;111(3):387-98.
doi: 10.1097/00005537-200103000-00005
Manikandan N. Effect of facial neuromuscular re-education on facial
symmetry in patients with Bell’s palsy: a randomized controlled
trial. Clin Rehabil. 2007;21:338-343. doi: 10.1177/0269215507070790
Carvalho AR, Fungueto EM, Canzi IM, Barbieiro C, Moraes V,
Bertolini GRF, Aragão FA. Correntes diadinâmicas de Bernard
e iontoforese no tratamento da dor lombar. Fisioter Mov.
;18(4):11-9.
Artioli DP, Eloísa Sanches PN, Santos JC, Celeste LFN, Santini L,
Junior MCA, et al. Using polarized current in Physiotherapy.
Rev Bras Clin Med. 2011;9(6):428-31.
Bernal G. Helium neon and diode laser therapy is an effective
adjunctive therapy for facial paralysis. Laser Ther. 1993;5:79-87.
Almeida JR, Guyatt GH, Sud S, Dorion J, Hill MD, Kolber MR, et al.
Management of Bell palsy: clinical practice guideline. CMAJ.
;186(12):917-22. doi: 10.1503/cmaj.131801
Fonseca KMO, Mourão AM, Motta AR, Vicente LCC. Scales
of degree of facial paralysis: analysis of agreement. Braz J
Otorhinolaryngol. 2015;81:288-93. doi: 10.1016/j.bjorl.2014.04.005
Alakram P, Puckree T. Effects of electrical stimulation on HouseBrackmann scores in early Bell’s palsy. Physiother Theory Pract.
;26(3):160-6. doi: 10.3109/09593980902886339
Kleiss IJ, Hohman MH, Susarla SM, Marres HAM, Hadlock TA.
Health-related quality of life in 794 patients with a peripheral
facial palsy using the FaCE Scale: a retrospective cohort study.
Clin Otolaryngol. 2015;40:651-6. doi: 10.1111/coa.12434
Tavares-Brito J, van Veen MM, Dusseldorp JR, Bahmad F Jr,
Hadlock TA. Facial Palsy-Specific Quality of Life in 920 Patients:
Correlation With Clinician-Graded Severity and Predicting
Factors. Laryngoscope. 2019;129(1):100-4. doi: 10.1002/
lary.27481
Adour KK, Douglas NB, Wingerd J. Bell palsy, dilemma
of diabetes mellitus. Arch Otolaryngol. 1974;99(2):114-7.
doi: 10.1001/archotol.1974.00780030120009
Al-Azawi LM, Mirza KB. The usefulness of the brainstem
auditory evoked potential in the early diagnosis of cranial nerve
neuropathy associated with diabetes mellitus. Electromyogr.
Clin Neurophysiol. 2004;44(7):387-94.
Kiziltan ME, Uluduz D, Yaman M, Uzun N. Electrophysiological
findings of acute peripheral facial palsy in diabetic and
non-diabetic patients. Neurosci Lett. 2007;418(3):222-6.
doi: 10.1016/j.neulet.2007.03.028
Abraham-Inpijn L, Oosting J, Hart AAM. Bell’s palsy: factors
affecting the prognosis in 200 patients with reference
to hypertension and diabetes mellitus. Clin Otolaryngol.
;12(5):349-55. doi: 10.1111/j.1365-2273.1987.tb00215.x
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Copyright (c) 2020 Angela Juliana Cappeli, Hélio Rubens de Carvalho Nunes, Mônica de Oliveira Orsi Gameiro, Rodrigo Bazan, Gustavo José Luvizutto
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